Pulse(35)

Grant was alarmed by my sigh.

‘Are you all right?’ he asked for the umpteenth time, worry lines etched across his forehead.

‘I’m fine,’ I said. ‘Just tired.’

‘Are you hungry?’ he asked. ‘Shall I get you something now? We didn’t have any lunch.’

Was I hungry? Hunger was something I tried not to think about.

But I should be, I thought. Not only hadn’t I eaten any lunch, but I’d had no breakfast either. And absolutely nothing to eat the previous day. I’d been too excited at the prospect of working again to have any breakfast and I simply didn’t have time during the day to even grab a sandwich. I had intended having a chicken breast for supper, but I’d never made it home.

There’d been some improvement in my eating since my admission to Wotton Lawn but it remained low on my list of priorities, very low.

‘How about a cheese omelette?’ Grant asked.

‘That would be lovely,’ I said. I smiled at him and he smiled back, but his was a smile full of worry rather than one of love.

What was happening to me?

Why couldn’t I be well and normal?

I believed that I must have some resolution of my problems before I could even start to get better, but I still didn’t know what the problems were, let alone how to resolve them. They had something to do with my parents and my childhood but I couldn’t figure out exactly what.

Maybe there was no single cause, and no magic solution.

My psychotherapist continually encouraged me to talk about my emotions with regard to my mother and father, but I would often leave the session more confused and distressed than I had been beforehand. It was almost as if talking about my childhood unhappiness stirred everything up again, like shaking up the sediment in a bottle of excellent vintage Bordeaux – it made the whole contents unpalatable. Perhaps it would be far better to leave things undisturbed, decant and enjoy the fine wine above, and then cast away the bitter sediment with the empty bottle.

But I remained driven to find ‘the main cause’, to run round and round in circles searching like a dog that has lost a ball in the long grass. Only maybe there was no ball to find at all. Somehow, even though I knew it was madness, I was impelled to go on looking, and all my other problems had to wait.

I desperately wanted to break out of this cycle of misery but no one had told that to my unconscious mind, which went on working in its own mysterious and enigmatic manner.

‘Here you are,’ Grant said, placing a tray down on my lap. He had prepared not only an omelette but also a large bowl of fruit generously covered with Greek yogurt.

I smiled up at him. ‘Thank you, darling.’

Grant did his best but he didn’t really comprehend what was happening to me. Neither did I at times. From the outside, an eating disorder was impossible to understand and, from the inside, impossible to explain. Most of my friends grasped even less than Grant.

‘Surely it’s just a matter of free will,’ one of them said to me. ‘You must be able to eat if you want to.’

But I did want to eat. If I had learned only one thing in hospital it was how dangerous my situation had become and, without more food, I would certainly die, probably from heart failure. I had used up all the fat in my body and had started consuming my muscle tissue simply to survive – and the heart is a muscle. I was slowly devouring the very organ I needed most.

Eighteen months ago, for my fortieth birthday party, I had struggled to fit into my favourite dress – a low-cut sexy black number. It had been a struggle because, whereas the dress was a size 12, my body had, in truth, been closer to a size 14. But, as a fairly tall woman of five feet eight inches, I’d been rounded rather than chubby, weighing in at just under twelve stone.

Things had all changed dramatically the following year.

I had started to view my body as gross and disgusting, as if it were some alien creature from another planet that had to be defeated by starving it to death, and over the next six months, I had lost almost a third of my body weight.

That same sexy black dress now hung on my bony and protruding shoulders like a shapeless sack.

Yet the voice in my head still refused to believe the bleeding obvious and, with every mouthful I took, it became louder and more difficult to ignore.

Spit it out! Spit it out! it demanded.

Resisting the voice was a daily fight, and one I needed to win if I was to see my forty-second birthday.

Since leaving hospital, I had been winning, but I couldn’t let down my guard even for a day. I had been incredibly stupid not to have eaten anything on Tuesday and I was now paying the price.

Had I really been pushed? Or had I simply been too weak from lack of sustenance to notice the bus?

No one believed me and now I was beginning to doubt myself.

I ate the omelette and picked at the fruit. Grant urged me to finish it all but I was too full. I had been trying hard to gradually increase my daily intake but I still couldn’t eat a big meal. And it wasn’t safe for me to do so anyway.

Refeeding syndrome had been first recognised as a potentially fatal condition at the very end of the Second World War when some emaciated Japanese soldiers died after they had surrendered to the Americans in the Philippines. Too much food given to them too quickly had caused electrolytic disturbances in their red blood cells as essential minerals were diverted to their digestive tracts, resulting in insufficient oxygen being delivered to the brain and heart to maintain life.